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Individual

DR. JOHN LAURENCE EARL NUGENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 12TH AVE, SUITE 200, FORT WORTH, TX 76104-3926
(817) 850-2000
(817) 850-2065
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
E1091
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124554001
TX
05
124554002
TX
05
124554003
TX
05
124554005
TX
05
124554006
TX
05
124554008
TX
01
8R1516
BLUECROSS OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
03/11/2010
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